Scabies is a curable skin disease caused by the parasite,
Sarcoptes scabiei.

Scabies is transmitted through close physical contact with a
person who is infected or prolonged contact with infested linens,
furniture, or clothing.

Symptoms (most common itching) usually occur within 4 to 6
weeks after infection. Symptoms will begin within 1 to 4 days in a
person who has been infected with scabies before.

A person is considered infectious from the time of infestation
until treatment is successfully completed.

The only way for a person to know if he/she is infected with
scabies is through a test.

Secondary infection may occur due to continued, aggressive
scratching.

Crusted scabies, also known as Norwegian scabies, is a severe
infestation of scabies. It normally occurs in people with
compromised immune systems, such as the elderly and HIV-infected
individuals.

The only way to prevent infestation with scabies is avoid
direct contact with infested people, bed linens, clothing, and
furniture.

Latex condoms, while not considered to be effective against
scabies transmission, can prevent the transmission of other STDs.

What is
Scabies?

Scabies is an infestation of the top layer of skin caused by the
parasite, Sarcoptes scabiei, often called scabies or mites. The
female parasite burrows under the skin and begins laying eggs within
a few hours of infection and continues to lay 2 to 3 eggs daily. It
takes approximately 10 days for the eggs to hatch and become adult
mites. At this point, the cycle will begin again.

How is it transmitted?

Sexual Transmission:

Scabies are transmitted through close physical contact.
Transmission is more likely when partners spend the night together
than during a brief sexual encounter.

Nonsexual Transmission:

Sexual contact is not necessary to spread scabies. Prolonged
contact between household members may allow transmission to occur.
Transmission is also possible through prolonged contact with infested
linens, furniture, or clothing. It is unlikely that scabies would be
transmitted during casual contact (e.g. shaking hands or hugging) or
contact with inanimate objects, such as a toilet seat.

The type of scabies that infest humans is specific to human beings
and are different than the type that infest dogs and other animals,
more commonly known as mange. Mites from animals infested with mange
can burrow into human skin but cannot reproduce, and therefore die
within a few days.

How long before symptoms appear?

If a person has never been infected with scabies before, symptoms
appear approximately 4 to 6 weeks after infection. If a person has
been infected with scabies before, he/she will begin to experience
symptoms within 1 to 4 days after infection, because of previous
exposure to scabies.

How long is a person considered
infectious?

A person is considered infectious from the time he/she becomes
infected until treatment is successfully completed. Linens and
clothing are considered infectious until treatment or until 2 weeks
after the last exposure. After treatment, a person may unknowingly
become reinfested through exposure to the primary source of contact
or contact with a different infested source.

Symptoms

Persistent itching that usually becomes worse at night.

Presence of the mite burrow(s), often in a zigzag or "S"
pattern.

Presence of lesions, such as brown nodules, rashes, or
pimple-like irritations.

Common sites of infestation are: webs and sides of fingers and
toes, pubic and groin area, armpits, bends of elbows and knees,
wrists, navel, breasts, lower portion of buttocks, penis and scrotum,
waist and abdomen; rarely, they are found on the palms of the hands,
the soles of the feet and the neck upward.soles of the feet and the
neck upward.

Testing/Diagnosis

Microscopic Exams of Scrapings from Suspicious Lesion(s).
Scrapings are placed on a slide and examined under a microscope to
determine whether scabies are present.

Burrow Ink Test (BIT). The suspicious area is rubbed with ink from
a fountain pen. The surface is then wiped off with an alcohol pad; if
the person is infected with scabies, the characteristic zigzag or S
pattern of the burrow across the skin will appear.

Topical Tetracycline Solution. A topical tetracycline solution may
be applied to the suspicious area as an alternative to the BIT. The
excess solution is wiped off the area with alcohol and examined under
a special light to see if the characteristic zigzag or S pattern of
the burrow appear.

Shave Biopsies. A very fine layer of skin is shaved off at the
possible site of infestation and examined under a microscope for
evidence of mites.

Needle Extraction of Mites. A needle is carefully inserted into
the length of the burrow where the mite is likely living. The mite is
then extracted with the needle and placed on a slide to be examined
under a microscope.

Treatment

Recommended Treatment

Permethrin cream (RID®; A-200®)
The cream is applied in a thin layer to all areas of the body from
the neck down.
Rinse off after 8 to 14 hours.

Alternative Treatments

Lindane (Kwell®)
The cream is applied in a thin layer to all areas of the body from
the neck down.
Rinse off after 8 hours.
NOTE: Lindane (Kwell®)is potentially harmful and may cause
central nervous system complications, especially in children under
the age of two.

Lindane should not be used immediately after a bath or on
broken skin.

Lindane is not recommended to be used by the following
people:
women who are pregnant or lactating
children under 2 years of age
people with seizure disorders
people with extensive dermatitis or known allergies to any
ingredients found in Lindane.

Ivermectin
It is an oral treatment for scabies.
The medication is taken once initially and again after two
weeks.
NOTE:Ivermectin is not recommended for treatment of pregnant or
lactating women. It is unknown whether Ivermectin is safe for
children who weigh less than 30 pounds.

What Else Do I Need to Do to Get Rid of Scabies?

Use medication as directed.

Notify and treat all partners and household members.

Abstain from intimate or sexual contact until treatment is
completed successfully.